Background The current status of injury prevention implementation in top-level karate is unknown.

Objective To examine the current perceptions and practices of top-level karate athletes concerning risk-factors and injury prevention implementation.

Design Cross-sectional study based on face-to-face surveys.

Setting During the official medical meeting of the karate World Senior Championships (WSC) Madrid, 2018, the Chairman of the Word Karate Federation Medical Commission presented the project and invited the 131 team doctors to inform their athletes about the survey. Only athletes that accepted the invitation and speaking English, French, Slovak, Polish, Czecho and/or Spanish were involved in this study.

Patients (or Participants) Out of a total of 1117 athletes (140 countries/teams) that participated in the WSC, 137 (50 countries/teams) have completed the questionnaires (399 athletes didn’t speak any of the mentioned languages, 201 athletes didn’t volunteer and 380 couldn’t be reached)

Interventions (or Assessment of Risk Factors) The survey was constructed face to face and consisted of 15 questions.

Main Outcome Measurements The current perceptions and practices of top-level karate athletes concerning risk factors and injury prevention implementation.

Results Only 44.7% of the participant athletes have reported that their teams have conducted any preventive measures to reduce injury risk. Kumite athletes (51.2%) were more likely to practice injury prevention compared to kata athletes (25%; P=0.016). Athletes who received preliminary advices about injury prevention (58%) were more likely to practice it, compared to who did not receive any advice (20.5%; P<0.001). Athletes who have a fitness coach (part time or full time) were practicing more injury prevention strategies (66.7% and 51.4%, respectively) compared to athletes who do not have a fitness coach (35%; P=0.031).

Conclusions Injury prevention advices and the presence of a fitness coach are associated with an increase in the injury prevention practice. Action plans regarding injury prevention education should be implemented.